Minister for Health announces The interim Health Information and Quality Authority Research Awards

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Minister Mary Harney TD today announced that The interim Health Information and Quality Authority has awarded funding over the next three years to six important new research projects being undertaken in Ireland's health services. 

Speaking at the announcement of the interim Health Information and Quality Authority Health Research Awards, Minister Harney said; 'This research will inform the Authority's work of ensuring that world class, quality standards are applied in Ireland's health and personal social services - across the public, private and voluntary sectors. The Research Awards announced today reflect the diverse nature of the Authority's work and include research in areas such as cancer screening, general practice, the disability sector and hospital and community care'.

The Chairperson of the Authority, Mr. Pat McGrath, said 'A very large number of excellent project proposals were submitted to the Authority. The six successful projects were selected by a Board Sub-Committee chaired by Dr Ruth Barrington, CEO of the Health Research Board, using internationally recognised criteria. I would like to express my thanks to all the applicants and my congratulations to the successful ones. We in the Authority look forward to working closely with them over the next three years.'

Dr. Tracey Cooper, CEO of the interim Authority said; 'The new Health Information and Quality Authority has a very extensive remit. Our work will span the entire health service from promoting and implementing structured programmes of quality assurance; overseeing accreditation; developing health technology assessment, evaluating health information and reviewing and reporting on selected services every year. It is critical that our work is informed by the most extensive and up to date research available, whether that research is conducted in Ireland or internationally'.

The Health Information and Quality Authority will be established under the Health Bill 2006, which is currently before the Dail. The Social Services Inspectorate and the Irish Health Services Accreditation Board will form part of the new Authority. The new Authority will be established on a statutory basis within the next few months, once the health bill legislation is passed. In the meantime the interim Authority is undertaking a considerable amount of work, including the funding of the research projects announced today, to ensure that it will be in a position to commence its work immediately the legislation is passed.

A synopsis of the projects funded today by the interim Health Information and Quality Authority is outlined below.

Synopsis of Research Projects Funded by iHIQA.

Integrated Care Pathways at the End of Life for Patients in Hospital or the Community - Developing a Seamless Regional Care Pathway.

Researcher: Eoin Tiernan MD FRCPI MICGP Eoin is the Clinical lead for specialist Palliative care services for the HSE east coast area; he is also the Medical Director of Blackrock Hospice and Consultant at St.Vincent's Hospital

Synopsis: Approximately 30,000 people die each year in Ireland. Major international studies have highlighted the distress experienced by many in the terminal stages of life, despite advances in palliative care. No such large population-based studies have been undertaken to date in Ireland.

The Liverpool Care Pathway (LPC - developed in the UK) is a framework designed to support the transfer of the hospice model of terminal care to the acute hospital and primary care settings. The palliative care team at St. Vincent's University Hospital has adopted the LPC in St. Vincents and now seeks to extend the project to the other acute hospitals in the St Vincents Healthcare Network and within the HSE East Coast Area and to target pilot sites in the community hospitals, nursing homes and patient's own homes. The aim is to support patients dying in their place of preference, where possible, and to ensure standardization of best practice and terminal care in all settings.

The funding from iHIQA will support a critical appraisal of the transferability of the LPC into an Irish setting, and will seek to adapt it, adding other elements as appropriate, with the ultimate aim of producing a comprehensive end of life care pathway that will support a national quality improvement programme on integrated end of life care.

A User Configurable National Electronic Health Record: Technological Assessment of the EHRcom Standard for Ireland

Researcher: Damon Berry MSc. BSc. DipEE

Synopsis: The Electronic Health Record (EHR) is the term used to describe the amalgamation of all the useful clinical information that has been collected and stored by different people in different locations about a patient from birth to death. The key features of the EHR are that it is patient centred and all information can be accessed from one place, no matter where the information is physically held.

Such a system has yet to be implemented fully in Ireland since as yet there is no agreement between IT providers on ways of sharing information. The inability to share patient records across enterprises is one of the key problems in health informatics.

There are several standardisation 'projects' addressing this need to digitally represent and share clinical data. The central thrust of the health informatics standardisation has been towards a European standard for health record communication called EHRcom.

A technological assessment of the five part EHRcom standard in line with iHIQA roles forms the central tenet of the research project. This research contributes to iHIQA's role by providing a framework to introduce quality health information that meets nationally agreed standards for decision-making, planning and delivery of services. The impact of the research findings will in the medium term, provide a set of detailed recommendations for the development of electronic communication that will support a national EHR programme for Ireland, leading to a longer term impact of realising a National EHR infrastructure. The benefits of such a framework to patients will be to safeguard privacy and confidentiality whilst promoting the optimal use of high quality efficient and effective health information systems.

Developing the optimal strategy and tools for creating and implementing a colorectal cancer screening program: a program to assess and to develop capacity and capability in a national treatment centre

Researcher: Professor Colm O'Morain, MSc Biochemistry

Synopsis: A recent editorial in Am J Gastroenterology examined the role of Faecal Occult Blood testing (FOBT) in three countries, all three countries advocated the use of FOBT as a first line screening tool for colorectal cancer for their populations based on cost, uptake and reliability/sensitivity. Ireland has yet to develop a colon cancer screening service and a number of issues need to be addressed prior to this service plan being implemented.

The aim of this 3 year study; the results of which will be published and submitted to relevant policy makers as part of developing a quality assured national cancer screening service, is to ascertain the optimal tools and framework to be used in an Irish screening service based on (i) patient acceptability (ii) sensitivity and costs associated with the two types of FOBT and the associated long term costs of repeat tests/colonoscopies and (iii) the attitudes and awareness of the Irish public around colorectal cancer screening.

A randomized trial of two types of FOB test will be conducted on 20,000 male and female GP patients between the ages of 50 - 70 years. The process of the study will contribute to the accreditation process of the hospital laboratory and increase in the skill set involved in managing and processing large numbers of FOBT in a quality assured environment.

Developing quality indicators for use in general practice in Ireland

Researcher: Dr Ailis Ni Riain, MB BCh BAO, MICGP.

Synopsis: Despite the Irish College of General Practitioners (ICGP) producing guidelines supporting continuing medical education and promoting audit, there is little in the way of formal quality improvement initiatives or tools in quality improvement in general practice.

The aim of this study is to develop quality indicators for general practice in Ireland using the RAND/UCLA methodology that reflects the administration of general practice which broadly includes clinical conditions, the patient's experience and practice management issues.

The ICGP will actively promote and support their use through their small group continuing medical education network (95% of general practitioners are members of the ICGP). It is hoped that this will embed a culture of quality improvement in Irish general practice.

Morbidity and epidemiology in general practice in Ireland

Researcher: Dr Claire Collins, PhD, MsocSc, BsocSc, Dip Stats Director of Research (half time) in the Irish College of General Practitioners.

Synopsis: While there is data available on hospitals attendances in Ireland, little is known regarding general practice attendances. General practice is an untapped source of information about the health of our population, their behaviour and their utilisation of health services.

A sample of general practitioners will be recruited into a longitudinal data collection and analysis study.

The overall objective of this research is to provide a mechanism to collect data regarding morbidity among patients attending general practice and to describe general practice epidemiology, including health seeking behaviour, the consultation process, diagnostic and therapeutic outcomes and natural history of primary care illness.

The study will provide data on general practice morbidity and epidemiology. The data provided will indicate how better to promote healthy lifestyles and the enhanced management of disease.

Development and evaluation of a consumer driven standards and monitoring system for use within the disability sector

Researcher: Dr. Patricia O'Brien, Director of the National Institute for the Study of Learning Difficulties, School of Social Work and Social Policy, Trinity College Dublin

Synopsis: The aim of this project is to research and develop a means whereby consumers can be involved, in a very practical and central way, in the process of standards development and evaluation for services.

The service user will be central to the work, ethos and culture of the Health Information and Quality Authority and this project aligns closely with this.

The National Institute for Intellectual Disability, Trinity College will lead this project but will work alongside key stakeholders including the National Disability Authority, Inclusion Ireland, the Interim Authority, service agencies, such as, Moore Abbey, Cheshire Ireland, people with disability, family members and advocates and the members of the Social Services Inspectorate.

One of the key objectives of the projects is the training of service users in the evaluation process for services and incorporating the research learning into the standards as they evolve.